Provider Demographics
NPI:1063252146
Name:S WALIA DENTAL CORPORATION
Entity type:Organization
Organization Name:S WALIA DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUMANPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:WALIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-242-1440
Mailing Address - Street 1:7739 AMADOR VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2303
Mailing Address - Country:US
Mailing Address - Phone:925-833-9500
Mailing Address - Fax:
Practice Address - Street 1:7739 AMADOR VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2303
Practice Address - Country:US
Practice Address - Phone:925-833-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty